The Contribution of Personal and Occupational Factors to Shared Trauma and Professional Post-Traumatic Growth among Mental Health Professionals During "Swords of Iron" War

Background: The ״ Swords of Iron " war, which began on October 7, 2023, involved extensive attacks on IDF bases, communities in the Gaza periphery, and the "Nova" festival site, alongside the firing of thousands of rockets towards Israel (Blank et al., 2024; Pitcho, 2024). This war, which affected the entire population, is defined as collective trauma (Cypress, 2021). Additionally, it can be characterized as a ״Shared Traumatic Reality״, a situation in which mental health professionals (therapists) are part of the affected community and are therefore both exposed to and impacted by the events, while simultaneously providing aid and various therapeutic interventions to those affected within that community. In this situation, therapists are exposed both directly and indirectly to the traumatic event through the therapeutic relationship (Baum, 2010; Dekel et al., 2016; Ali et al., 2023). Direct and indirect exposure to traumatic events can lead to negative consequences, such as shared trauma, which consists of personal-secondary trauma and specific professional skills. Personal-secondary trauma is a specific type of secondary traumatization, where content brought up by clients regarding collective trauma events may serve as a trigger for therapists, causing them to avoid discussing it, which can result in empathic failure (Tosone et al., 2021, p. 4). Moreover, therapists may use professional skills such as self-disclosure and boundary blurring (Baum, 2010; 2014; Tosone et al., 2012; Tosone & Cohen-Serrins, 2023). Alongside these negative effects, there may also be positive outcomes, such as "Post-Traumatic Professional Growth" (Tosone et al., 2016).

Research Objective: Studies concerning both the phenomenon of shared trauma and post-traumatic professional growth, as well as the variables that contribute to their development, present inconsistent findings. Moreover, research on collective trauma events, such as war, has often been conducted months or even years after the conflict has ended. The current study aims to examine the contribution of personal and occupational variables among therapists to shared trauma and post-traumatic professional growth, based on Tosone's model (Tosone et al., 2016), in the immediate aftermath of the outbreak of the ״Swords of Iron" war.

Method: The study was quantitative and correlative, conducted among 183 mental health professionals: social workers, psychologists, psychiatrists, and art therapists. The participants responded to six questionnaires between November 9, 2023, and December 31, 2023: (a) Personal-professional questionnaire; (b) Shared Trauma and Post-traumatic Professional Growth Questionnaire; (c) Traumatic events exposure questionnaire during the war and prior; (d) Acute Stress Symptom Severity Questionnaire for adults; (e) Supervision and work support questionnaire; and (f) questions regarding the intensity of work-family conflict, professional efficacy, and role clarity. This research is based on data collected as part of a study led by Dr. Tamar Lavi from NATAL, Prof. Rachel Dekel from Bar-Ilan University, and Prof. Zahava Solomon from Tel Aviv University.

Findings: The findings of the current study indicate that, at the onset of the "Swords of Iron" war, therapists' exposure to a potentially traumatic event prior to the war correlates with lower levels of personal-secondary trauma. Additionally, a higher intensity of work-family conflict was found to correlate with increased personal-secondary trauma and greater use of professional skills. Furthermore, younger age of therapists correlates with reduced use of professional skills. Moreover, exposure to a greater number of potentially traumatic events during the war and receiving more supervision correlates with greater post-traumatic professional growth. Regarding the study’s findings on mediation, it was found that post-traumatic distress from wartime events mediates the correlation between work-family conflict and personal-secondary trauma, professional skills, and post-traumatic professional growth. It was also found that post-traumatic distress from wartime events mediates the correlation between therapists' age and personal-secondary trauma.

Discussion: The current study is the first to examine shared trauma and post-traumatic professional growth among mental health practitioners at the onset of the ״Swords of Iron" war, as well as the first to explore the contribution of personal and occupational variables as risk and resilience factors. The study findings suggest that post-traumatic professional growth can be identified shortly after the beginning of a collective trauma event, such as the ״Swords of Iron" war, alongside relatively low levels of post-traumatic distress. Additionally, the research findings highlight the necessity of providing supervision to promote the process of post-traumatic professional growth. Furthermore, the findings suggest the need to support therapists experiencing loyalty conflicts between their family roles and professional duties during a collective trauma event, as this conflict is related to the use of specific professional skills within the therapeutic setting.